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Archives of Breast Cancer - Volume:2 Issue: 3, Aug 2015

Archives of Breast Cancer
Volume:2 Issue: 3, Aug 2015

  • تاریخ انتشار: 1394/07/09
  • تعداد عناوین: 7
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  • Mohamadreza Neishaboury, Kamelia Davoodzadeh, Mojgan Karbakhsh Pages 75-78
    Background
    Embarrassment and shame of visiting a doctor for a breast disease are among psychosocial factors that potentially contribute to delay in seeking medical advice. The purpose of this study is to review the published literature to determine if embarrassment regarding breast examination, diagnosis and treatment is associated with patient delay.
    Methods
    We searched PubMed with the following key terms: patient acceptance of health care (MeSH), breast neoplasms/psychology (MeSH), shame (MeSH), embarrassment, delayed diagnosis, to find relevant literature published before August 2015.
    Results
    The studies that explicitly assessed the association between embarrassment and delay for seeking medical advice for breast cancer were very limited. Among these studies, only 2 were quantitative studies, 4 were based on qualitative research and 4 were reviews. Other studies assessed attitudes in population-based surveys or included patients (females and males) suffering from different types of cancer.
    Conclusions
    Women should be educated that diseases of the breast need to be cared for as health issues in other parts of the body. They should be informed that embarrassment in this regard is not related to grace and integrity but can be potentially life-threatening. Further research is necessary to quantify the association of embarrassment or shame with delay in seeking diagnosis and treatment of breast cancer. More research can elucidate the ways that the negative impact of shame/embarrassment can be minimized in different ethnic groups.
  • Fezzeh Elyasinia, Farham Ahmadi, Massoome Najafi, Habibollah Mahmoodzadeh, Hossein Khalili, Mohammad Reza Keramati, Reza Parsaei, Ahmad Kaviani Pages 79-84
    Background
    Modified radical mastectomy (MRM), as a surgical treatment in breast cancer patients, may lead to important complications with significant morbidities including seroma formation. In this study, we used topical phenytoin to evaluate its impact on breast and axillary wound drainage and seroma formation after MRM.
    Methods
    In a double-blinded randomized clinical trial, patients with breast cancer who were candidates for modified radical mastectomy (MRM) were enrolled. The patients were randomly assigned to two groups using a simple randomization method. Group A received topical phenytoin 1% solution for the irrigation of the mastectomy wound during the MRM procedure while group B (control group) underwent wound irrigation with normal saline solution. In addition to demographic data, postoperative variables including daily drainage of breast and axillary drains, drain removal days, and possible complications including seroma formation and their management were recorded.
    Results
    Except for daily drainage recorded on the fifth postoperative day, the drainage of both axillary and breast drains were significantly different between group A and B in the following days. Compared to group B, axillary drains could be removed significantly earlier in group A. In regard to the breast drains, they were removed earlier in group A with no statistically difference compared to group B, the difference was not statistically significant. Seroma was detected in 7(8.3%) patients, 3 patients in group A and 4 patients in group B, with no significant differences between the two groups. All the patients underwent repeated aspirations.
    Conclusions
    Our findings showed that topical irrigation of the surgery site with phenytoin was effective in reducing axillary surgical wound drainage.
  • Kasra Karvandian, Sanaz Shabani, Jayran Zebardast Pages 85-90
    Background
    Acute postoperative pain is an important surgical side effect that may delay patient discharge in ambulatory operations; moreover, the strategies used to alleviate pain may cause side effects that require longer hospitalization to recover. In this clinical trial, we compared two current anesthetic methods with special concerns about postoperative pain intensity beside other important components of ambulatory anesthesia.
    Methods
    This clinical trial was conducted on two age-matched groups of 75 members who underwent ambulatory breast surgery. Patients in the first group (GA) underwent general anesthesia with propofol plus remifentanil by employing a laryngeal mask airway. In the second group (LA), the surgeon used infiltration of 2% lidocaine in the breast tissue and midazolam was applied as premedication. At the end of surgery, paracetamol was administered to all patients in both groups. The pain score was evaluated when the patients were fully awake using a numerical pain rating scale. Patients with severe pain received analgesia. The length of postanesthesia care unit (PACU) stay was recorded for each patient.
    Results
    None of the patients in the LA group were satisfied because of the experience of needle insertion into their breast tissue (P = 0.001). The patients in the LA group experienced more pain in PACU requiring adjuvant analgesia (P = 0.001). Patients in the LA group had longer PACU admission (P = 0.001).
    Conclusions
    Patients in the LA group had higher pain scores and were dissatisfied with the plan of their anesthesia. This may confirm the role of preemptive analgesia or the effect of emotional stress of breast tissue needling in wakeful patient.
  • Behzad Mohaddesi, Ashvin Dudhrejiya, Navin R. Sheth Pages 91-95
    Background
    In the modern lifestyle, the increase in cancer and related chronic disorders is a major public health problem. In spite of different methods used for the treatment of these conditions, natural medicines have high demands due to their significant effects as immune enhancement and therapeutic agents and fewer side effects in comparison with other treatment methods. Hence, this study was undertaken to evaluate the cytotoxic effect of cardiospermum halicacabum Linn. seeds, based on traditional claims.
    Methods
    A Soxhlet extractor was used to obtain different extracts from seeds of C. halicacabum Linn. Sulforhodamine B colorimetric (SRB) assay used for the evaluation of the cytotoxic effect of the various extracts on HT-29, HCT-15 colon carcinoma, SK-MEL-2 skin carcinoma, and MCF-7 breast carcinoma. The results were compared against Doxorubicin as a standard drug.
    Results
    The results of the present study showed the potent cytotoxic activity of n-hexane extract of seeds of C. halicacabum Linn. against the MCF-7 breast cancer cell line with 50% growth inhibition value (GI50) of 12.8 μg/ml but other extracts showed poor activity in other tested cell lines.
    Conclusions
    The results indicated the potential medicinal value of C. halicacabum Linn. seeds oil with the highest extractive yield as an antineoplastic agent. However, further studies are needed for the isolation of the active anticancer compounds and evaluating the mechanism of action of the responsible compound.
  • Amir, Hassan Matini, Afshin Abdirad, Ramesh Omranipour, Reza Shahsiah Pages 96-99
    Background
    Studies have shown that obese individuals are at increased risk of breast cancer development and poorer prognosis. Leptin, an adipose tissue-derived hormone, has pro-inflammatory and proliferative effects and a well-established association with several comorbidities of obesity. This study was designed and conducted to compare the serum levels of leptin in patients with malignant and benign breast lesions.
    Methods
    A cross-sectional study was conducted in Research Center of Cancer Institute, Tehran, Iran between 2010 and 2011. Sixty-five patients with breast cancer and 65 BMI-matched patients with benign breast lesions were enrolled in this study. The serum leptin level was measured by the ELISA method and compared between the two groups.
    Results
    A total of 130 patients were collected. The mean BMI in benign and malignant groups was 25.2±3.2 and 25.8±3.8 (kg/m2), respectively. Circulating levels of leptin were 20.05±14.69 vs. 14.74±10.16 mL in malignant and benign groups, respectively (P=0.011). A positive correlation was observed between BMI and leptin concentration (r = 0.431, P < 0.001). Leptins levels were not associated with the patients’ age (P = 0.108), menstrual status (P = 0.214), and history of OCP use (P = 0.269).
    Conclusions
    Our findings suggest that patients with breast cancer have significantly higher levels of leptin compared to those with benign lesions.
  • Pallavi Agrawal, Neha Garg, Braj B. Pandey Pages 100-103
    Background
    Primary leiomyosarcoma (LMS) of the breast is a very rare neoplasm of the breast arising from the mesenchymal tissue. The clinical presentation of this entity simulates other benign and malignant lesions of mesenchymal tissue of the breast.
    Case Presentation
    Case 1: A 40-year-old female presented with a right-sided breast lump, which was suspected to be a malignant spindle cell tumor on needle core biopsy (NCB). A multi-disciplinary team performed modified radical mastectomy (MRM) with axillary node dissection on the patient with no post-operative chemo-radiation. Case 2: A 70-year-old female presented with a left sided breast lump and a palpable axillary node. Needle core biopsy diagnosed it as malignant spindle cell tumor. The patient underwent MRM with axillary node dissection. It was confirmed to be a case of breast LMS with axillary nodal metastasis. Both patients were followed up for one year with no evidence of recurrence.
    Conclusion
    Both cases underwent MRM with axillary node dissection in our study. However, the role of axillary dissection in the prognosis and disease-free survival of the patients with primary LMS of the breast with axillary metastasis has not been studied yet. The optimal management of this entity remains to be tumor excision with clear margins.